Surgical Fixation of Metacarpophalangeal Collateral Ligament Rupture of the Fingers.
Collateral Ligaments
/ injuries
Disability Evaluation
Feasibility Studies
Female
Finger Injuries
/ complications
Follow-Up Studies
Humans
Male
Metacarpophalangeal Joint
/ injuries
Middle Aged
Orthopedic Procedures
/ adverse effects
Range of Motion, Articular
Plastic Surgery Procedures
/ adverse effects
Reproducibility of Results
Retrospective Studies
Rupture
/ surgery
Suture Anchors
Treatment Outcome
Journal
Plastic and reconstructive surgery
ISSN: 1529-4242
Titre abrégé: Plast Reconstr Surg
Pays: United States
ID NLM: 1306050
Informations de publication
Date de publication:
05 2019
05 2019
Historique:
entrez:
30
4
2019
pubmed:
30
4
2019
medline:
23
5
2019
Statut:
ppublish
Résumé
Collateral ligament injury of the metacarpophalangeal joint of the fingers is underreported in the literature and widely underestimated by the medical community. Here, the authors present results from a large series of patients and review factors influencing success of surgery. The authors performed a retrospective study of 46 patients who underwent surgical fixation of the metacarpophalangeal collateral ligament using bone anchor in an acute or chronic setting. The diagnosis was predominantly clinical, based on laxity testing of the joint. The authors collected demographic data and intraoperative findings and postoperative results. Following surgery, with a median follow-up of 17 months, all patients presented with a stable joint and complete resolution of pain. The mean flexion of the metacarpophalangeal joint was 77.11 degrees, and mean extension was 0.84 degrees. The authors measured the injured grip strength at a mean of 88.52 percent of the opposite hand, and the mean Quick Disabilities of the Arm, Shoulder and Hand questionnaire score used to evaluate disability was 9.56 on a scale of 100 (with 100 being complete disability). Surgical treatment of metacarpophalangeal collateral ligament rupture of the fingers is a safe technique that gives reproducible positive results in terms of mobility, strength, and disability scale score. The authors' results show that anchoring of the ligament should be performed even with prolonged time from injury to surgery.
Sections du résumé
BACKGROUND
Collateral ligament injury of the metacarpophalangeal joint of the fingers is underreported in the literature and widely underestimated by the medical community. Here, the authors present results from a large series of patients and review factors influencing success of surgery.
METHODS
The authors performed a retrospective study of 46 patients who underwent surgical fixation of the metacarpophalangeal collateral ligament using bone anchor in an acute or chronic setting. The diagnosis was predominantly clinical, based on laxity testing of the joint. The authors collected demographic data and intraoperative findings and postoperative results.
RESULTS
Following surgery, with a median follow-up of 17 months, all patients presented with a stable joint and complete resolution of pain. The mean flexion of the metacarpophalangeal joint was 77.11 degrees, and mean extension was 0.84 degrees. The authors measured the injured grip strength at a mean of 88.52 percent of the opposite hand, and the mean Quick Disabilities of the Arm, Shoulder and Hand questionnaire score used to evaluate disability was 9.56 on a scale of 100 (with 100 being complete disability).
CONCLUSIONS
Surgical treatment of metacarpophalangeal collateral ligament rupture of the fingers is a safe technique that gives reproducible positive results in terms of mobility, strength, and disability scale score. The authors' results show that anchoring of the ligament should be performed even with prolonged time from injury to surgery.
Identifiants
pubmed: 31033824
doi: 10.1097/PRS.0000000000005575
pii: 00006534-201905000-00027
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1421-1428Commentaires et corrections
Type : CommentIn
Références
Gaston RG, Lourie GM. Radial collateral ligament injury of the index metacarpophalangeal joint: An underreported but important injury. J Hand Surg Am. 2006;31:1355–1361.
Delaere OP, Suttor PM, Degolla R, Leach R, Pieret PJ. Early surgical treatment for collateral ligament rupture of metacarpophalangeal joints of the fingers. J Hand Surg Am. 2003;28:309–315.
Dray G, Millender LH, Nalebuff EA. Rupture of the radial collateral ligament of a metacarpophalangeal joint to one of the ulnar three fingers. J Hand Surg Am. 1979;4:346–350.
Ishizuki M. Injury to collateral ligament of the metacarpophalangeal joint of a finger. J Hand Surg Am. 1988;13:444–448.
Lutsky K, Matzon J, Walinchus L, Ross DA, Beredjiklian P. Collateral ligament laxity of the finger metacarpophalangeal joints: An in vivo study. J Hand Surg Am. 2014;39:1088–1093.
Moberg E, Stener B. Injuries to the ligaments of the thumb and fingers; diagnosis, treatment and prognosis. Acta Chir Scand. 1953;106:166–186.
Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: The DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996;29:602–608.
R Core Team. R: A Language and Environment for Statistical Computing. 2016.Vienna, Austria: R Foundation for Statistical Computing.
Bain GI, Polites N, Higgs BG, Heptinstall RJ, McGrath AM. The functional range of motion of the finger joints. J Hand Surg Eur Vol. 2015;40:406–411.
Dy CJ, Tucker SM, Kok PL, Hearns KA, Carlson MG. Anatomy of the radial collateral ligament of the index metacarpophalangeal joint. J Hand Surg Am. 2013;38:124–128.
Werner D, Kozin SH, Brozovich M, Porter ST, Junkin D, Seigler S. The biomechanical properties of the finger metacarpophalangeal joints to varus and valgus stress. J Hand Surg Am. 2003;28:1044–1051.
Wolfe SW, Hotchkiss RN, Pederson WC, Kozin SH, Cohen MS. Green’s Operative Hand Surgery. 2017.7th ed. Philadelphia: Elsevier.
Rozmaryn LM. The collateral ligament of the digits of the hand: Anatomy, physiology, biomechanics, injury, and treatment. J Hand Surg Am. 2017;42:904–915.
Riederer S, Nagy L, Büchler U. Chronic post-traumatic radial instability of the metacarpophalangeal joint of the finger: Long-term results of ligament reconstruction. J Hand Surg Br. 1998;23:503–506.
Doyle JR, Atkinson RE. Rupture of the radial collateral ligament of the metacarpo-phalangeal joint of the index finger: A report of three cases. J Hand Surg Br. 1989;14:248–250.
Wong JC, Lutsky KF, Beredjiklian PK. Outcomes after repair of subacute-to-chronic grade III metacarpophalangeal joint collateral ligament injuries in fingers are suboptimal. Hand (N Y) 2014;9:322–328.
Ishizuki M, Sugihara T, Wakabayashi Y, Shirasaka R, Aoyama H. Stener-like lesions of collateral ligament ruptures of the metacarpophalangeal joint of the finger. J Orthop Sci. 2009;14:150–154.
Stener B. Displacement of the ruptured ulnar collateral ligament of the metacarpophalangeal joint of the thumb. J Bone Joint Surg Br. 1962;44:869–879.
Toffoli A, Chammas M. Stener-like lesions due to radial collateral ligament rupture in the metacarpophalangeal joints of two adjacent fingers: A case report and review of literature. Hand Surg Rehabil. 2017;36:141–145.